According to the U.S. Department of Health and Human Services, January is cervical cancer awareness month. Cervical cancer is known as a gynecological cancer because it starts in a woman’s reproductive organs. In addition to cervical cancer, other gynecological cancers can include ovarian, uterine, vaginal and vulvar cancer. Each display different signs and symptoms, risk factors and prevention strategies. With any gynecological cancer, early detection can improve outcomes. The American Cancer Society guidelines for the prevention and early detection of cervical cancer recommend:
• All women should begin cervical cancer testing (screening) at age 21.
• Women aged 21 to 29, should have a Pap test every 3 years. HPV testing should not be used for screening in this age group unless it is needed as after an abnormal Pap test result.
• Beginning at age 30, women should be screened with a Pap test combined with an HPV test every 5 years as long as the test results are normal. This is called co-testing and should continue until age 65.
Another reasonable option for women 30 to 65 is to get tested every 3 years with only the Pap test.
• Women over age 65 who have had regular screening in the past 10 years with normal results should stop cervical cancer screening. Once stopped, it should not be started again.
Women with a history of a serious pre-cancer, such as CIN2 or CIN3 should continue to have testing for at least 20 years after that condition was found, even if the testing goes past age 65.
• Women who have had a total hysterectomy (removal of the uterus and cervix) should stop screening (such as Pap tests and HPV tests), unless the hysterectomy was done as a treatment for cervical pre-cancer (or cancer). Women who have had a hysterectomy without removal of the cervix (called a supra-cervical hysterectomy) should continue cervical cancer screening according to the guidelines above.
• Women who are at high risk of cervical cancer because of a suppressed immune system (for example from HIV infection, organ transplant, or long-term steroid use) or because they were exposed to DES in utero may need to be screened more often. They should follow the recommendations of their health care team.
• Women of any age should NOT be screened every year by any screening method if their Pap tests have been normal and they do not have HIV infection or other cause for a weakened immune system.
• Women who have been vaccinated against HPV should still follow these guidelines for their age groups.
Please note these guidelines do not apply to women who have been diagnosed with cervical cancer or cervical pre-cancer. Talk to your health care provided with any questions or concerns and the best course of action for you. For direct links on risk factors, understanding test results, diagnosis and treatment visit your nodawaypublichealth.org.
Kathryn Hawley, RN & Health Educator, Nodaway County Health Dept.